Managing Late and Long-Term Effects Among Swedish Adolescents and Young Adults Affected by Cancer Following a Wilderness Intervention: Reconnecting with Self and Meaning Through Nature's Unconditional Presence - A Qualitative Study.

IntroductionAdolescents and Young Adults (AYAs) affected by cancer are at risk of experiencing late and long-term effects following cancer diagnosis and treatment. While structured interventions have demonstrated potential benefits for well-being during the intervention itself, little is known about how AYAs affected by cancer engage with and experience nature in their everyday lives beyond the formal program context. The aim of this study was to explore how a selected group of AYAs affected by cancer-who had participated in a nature-based intervention (the WAYA program)-experience nature and its role in supporting and managing late and long-term effects of cancer and its treatment, beyond the context of the program itself.MethodThis qualitative study explored the experiences of nature following the WAYA intervention among AYAs affected by cancer. Data were collected by focus group interviews at a three-month follow-up, using participant-selected photographs as visual prompts to elicit reflection on how nature supports management of late and long-term effects of cancer. A photovoice-inspired approach guided discussion questions and facilitated individual and collective meaning-making. Interviews were audio-recorded, transcribed verbatim, and analyzed using qualitative content analysis.ResultsThe analysis of this study showed one theme: Reconnecting with self and meaning through nature's unconditional presence-beyond human connection. The theme comprises the two categories Nature as a resource for inner balance and Nature as a meaningful companion, and five sub-categories: Managing by being mindful, Managing by experiencing rest and being calm, Experiencing metaphoric recognition, Sparking comfort, hope and positive emotions, and Nature as a space without obligations.ConclusionThis study explored how AYAs affected by cancer engage with nature beyond formal programs, revealing its potential in better management of late and long-term effects. These findings can inform low-threshold, personal meaningful, and sustainable approaches to clinical practice, well-being, and rehabilitation for this vulnerable group.